The correlation between alcohol consumption and risky sexual behaviours among people living with HIV/AIDS

The objectives of this study were to determine if significant correlation exists between drinking any alcoholic beverage and risky sex among 326 AIDS patients. Participants completed anonymous surveys. The result of the regression and Pearson correlation analyses revealed a significant positive correlation between drinking alcohol before sex and frequency of condom use (p<0.0001). The number of sex partners respondents reported was also correlated with the frequency of alcohol use (p = 0.003). The result shows that the quantity of alcohol consumption was correlated with two indicators of risky sex: having multiple sexual partners (p<0.0001) and having sexual intercourse without a condom (p<0.001). Interventions are that integrate HIV risk reduction with alcohol risk reduction is very useful to minimize the risk of new HIV infections and/or manage existing infections.     

Predictors of HIV-related high-risk sexual behaviors among female substance users

This study aimed to explore predictors of human immunodeficiency virus (HIV)-related risky sexual behaviors among women with substance use. A total of 150 women were selected from harm reduction centers in Tehran, Iran, and completed the risk behavior assessment, the Beck depression inventory, the revised self-efficacy scale, and the peer group beliefs regarding HIV-related risk behaviors scale. The results showed that age (β = ?.07, P ? .01) and exchange of sex for drugs or money (β = 3.34, P ? .001) were significant predictors of whether women had multiple sex partners. Moreover, depression (β = .06, P ? .05), exchange of sex for drugs or money (β = 1.42, P ? .01), and self-efficacy (β = ?.19, P ? .001) significantly predicted unprotected sex among women with substance use. Accordingly, providing female substance users with harm reduction services and developing HIV prevention programs are likely to decrease high-risk sexual behaviors and consequent HIV infection within this vulnerable group.     

The sexual behaviour of physically disabled adolescents

Introduction.?Risky sexual behaviour is a major factor contributing to the increasing prevalence of HIV/AIDS in South Africa. A large national survey of adolescent's sexual behaviour was undertaken in 2002, however adolescents with disabilities were excluded from this study. The aim of this study is to compare the sexual behaviours of adolescents with physical disabilities to those of their non-disabled peers.

Methodology.?A cross-sectional sample was drawn from learners with physical disabilities between grades 8 and 9 in Cape Town. Data were collected using the South African youth risk behaviour survey adapted by the medical research council of South Africa.

Results.?There were responses from 91 participants, of which 56% were males. Approximately, one quarter of the special school sample reported sexual activity compared with one third of the national sample; the difference approached significance. As with the national sample, relatively few adolescents thought they were likely to contract HIV in their lifetime (12%). Fifty percent of the sample claimed that they were able to protect themselves against contracting HIV compared with 66% of the adolescents without disability. The percentage reporting two or more sexual partners in the special schools (27%) was about half that of the national sample (53%). There was little difference in the percentages reporting substance abuse related to sexual activity (14% compared with 15%) and the national sample reported more regularly use of condoms (Special school 18% compared with 25%).

Discussion.?Disabled adolescents are indulging in risky sexual behaviours, and are at equal risk as their non-disabled peers of developing HIV.

Conclusion.?Adolescents with disability must not be excluded from main stream research and health promotion activities specifically related to sex education.     

HIV/AIDS awareness in those diagnosed with mental illness

The spread of human immunodeficiency virus (HIV) continues to increase among the general population. Previous studies in this field focused mainly on the 'at-risk' groups such as homosexuals, prostitutes, intravenous drug users, bisexual men and women. Mentally ill men and women remain one of the subgroups understudied and yet continue to show disproportionately high levels of seroprevalence. The purpose of this study was to elucidate awareness of the risk factors associated with HIV transmission and development of AIDS in those diagnosed with mental illness. Using questionnaires, information regarding HIV method of transmission, knowledge on HIV/AIDS and at-risk behaviour awareness was obtained from 30 subjects in an acute psychiatric mental health unit (13 women and 17 men). Significant association between different variables was determined at 95.5% confidence level (P=0.05). Assessment of HIV/AIDS awareness and at-risk behaviour awareness revealed significant knowledge deficit among this subject group. The outcome of this study underscores the need to introduce intervention programmes tailored to individual needs of the mentally ill. Measures such as 'at-risk sexual' behaviours should be incorporated into the current assessment process or profile so that accurate information and informed judgement can be reached regarding client or patient sexual behaviour.     

Primary and preferred sources for HIV/AIDS and sexual risk behavior information among adolescents in Swaziland, Southern Africa

The HIV/AIDS epidemic in Sub-Saharan Africa poses a massive diffusion and persuasion challenge for health professionals. Individuals working with adolescents to prevent the spread of HIV/AIDS must gain an understanding of adolescent's preference in obtaining information about HIV/AIDS and sexual behaviors. This study describes the primary and preferred sources of information regarding HIV/AIDS and sexual risk behavior in relation to several socio-demographic variables (n=941) in Swaziland, Southern Africa. Although print/broadcast media was the primary source for HIV/AIDS and sexual risk behavior information for the students, most participants preferred information from the healthcare workers. This study suggests a greater role for healthcare providers in providing HIV/AIDS and sexual risk information.     

Small Islands, Big Problem: HIV/AIDS and Youth in Trinidad and Tobago

PROBLEM: In the Caribbean region, women and young girls are becoming infected with HIV at a 6:1 rate more than men. Our study investigated effective methods for reducing HIV/AIDS risks among adolescent girls in the Caribbean. METHODS: One hundred females, aged 15-21, were randomly assigned into a control or intervention group. Subjects were assessed at baseline and postintervention. FINDINGS: Analysis of variance revealed that items measuring feelings about self, perceived risk, and sexual attitudes had statistically significant postintervention increase. CONCLUSION: Sustainable HIV/AIDS prevention programs that address stigma, promote HIV testing, and reinforce safer sex practices are needed.     

Methamphetamine use and sexual risks for HIV infection in Cape Town,South Africa

Aims: The current study examined the use of methamphetamine (Meth) in relation to HIV risks in a South African community sample.

Design and setting: Street intercept methods were used to collect surveys of substance use and sexual behavior from 441 men and 521 women living in a racially mixed township in Cape Town South Africa.

Findings: Results showed that 78 (18%) men and 63 (12%) women had used Meth, and 49 (11%) men and 34 (6%) women ever had used Meth in the preceding 6 months. Other than alcohol, cannabis was the most commonly used drug followed by Meth. We found that Meth use was closely associated with other drug use, indicating a pattern of poly‐substance use among Meth users. Recent Meth use was associated with being male, engaging in unprotected intercourse and having multiple sex partners in the previous 6 months. Meth users also demonstrated greater condom use than non‐users, although less than half of all intercourse occasions among Meth users were condom protected.

Conclusions: Meth is used by a substantial number of people in one area of South Africa and the close association of Meth and sexual risk practices raises concern that Meth could fuel the spread of HIV infection in new South African sub‐populations.     

CD8+ T cells fail to limit SIV reactivation following ART withdrawal until after viral amplification

To define the contribution of CD8⁺ T cell responses to control of SIV reactivation during and following antiretroviral therapy (ART), we determined the effect of long-term CD8⁺ T cell depletion using a rhesusized anti-CD8β monoclonal antibody on barcoded SIVmac239 dynamics on stable ART and after ART cessation in rhesus macaques (RMs). Among the RMs with full CD8⁺ T cell depletion in both blood and tissue, there were no significant differences in the frequency of viral blips in plasma, the number of SIV RNA⁺ cells and the average number of RNA copies/infected cell in tissue, and levels of cell-associated SIV RNA and DNA in blood and tissue relative to control-treated RMs during ART. Upon ART cessation, both CD8⁺ T cell–depleted and control RMs rebounded in fewer than 12 days, with no difference in the time to viral rebound or in either the number or growth rate of rebounding SIVmac239M barcode clonotypes. However, effectively CD8⁺ T cell–depleted RMs showed a stable, approximately 2-log increase in post-ART plasma viremia relative to controls. These results indicate that while potent antiviral CD8⁺ T cell responses can develop during ART-suppressed SIV infection, these responses effectively intercept post-ART SIV rebound only after systemic viral replication, too late to limit reactivation frequency or the early spread of reactivating SIV reservoirs.     

HIV infection: Fear of contagion, reality of risk

Purpose:  The purpose of this presentation at the 2007 Annual Meeting of the Japan Academy of Nursing was to give an overview of the HIV pandemic from global, Asian, and Japanese perspectives and to address the issues related to potential occupational exposure to HIV infection. Selected topics in the areas of prevention, treatment, and care were also addressed.
Discussion:  The session challenged the audience to understand that, while there is a risk of acquiring HIV infection through occupational exposure, the reality is that health-care workers and others are much more likely to contract HIV through their own personal behaviour.     

Relationships of sexual imposition, dyadic trust, and sensation seeking with sexual risk behavior in young Urban women

This study was designed to examine the relationships of sexual imposition, dyadic trust, and sensation seeking with HIV sexual risk behavior in 257 young urban women. Interviews were conducted using Audio Computer-Assisted Self-Interview (ACASI). Hierarchical multiple regression revealed that sexual imposition, dyadic trust, and sensation seeking explained 18.3% of the variance in sexual risk behavior. Although sexual imposition was positively related to sexual risk, pressure to satisfy a male partner sexually was more common than physical coercion. Dyadic trust was negatively related, indicating that women engaged in sexual risk behavior with men they distrusted. Sensation seeking was positively related to sexual risk. Findings suggest the need for enhancing awareness of non-sexually imposing relationship alternatives and incorporating thrill and excitement in health promotion messages.     

Relationships between childhood sexual abuse and substance use and sexual risk behaviors during adolescence: An integrative review

Background

Childhood sexual abuse (CSA) is thought to be a precursor to substance use and sexual risk behaviors during adolescence. To inform adolescent prevention efforts, information is needed to explicate the nature of the relationships between CSA and these health risks. The aim of this study was to summarize the current literature on the associations between a history of CSA and substance use and sexual risk behaviors during adolescence.

Methods

We conducted a systematic literature search and an integrative review.

Results

Current evidence implicates CSA as a robust precursor to the use of a wide variety of substances and multiple sexual risk behaviors during adolescence.

Conclusion

Screening for CSA in adolescents at risk and incorporating strategies that enhance CSA recovery in adolescent prevention programs are warranted. Future research that includes longitudinal designs, uses multiple methods of assessment, and identifies pathways between CSA and adolescent health risks is recommended.     

Intervening to identify and reduce drug use and sexual HIV risk patterns among men who have sex with men in three provinces in South Africa

Formative work to inform interventions aimed at addressing drug and sexual risk behaviours among men who have sex with men (MSM) in South Africa highlighted the need to target drug-using MSM with prevention interventions addressing both sexual and drug-related HIV risk. From 2007, in collaboration with two local NGOs, intervention activities were rolled out to vulnerable drug-using MSM. Over the first two years, 3475 drug-using MSM were reached through community outreach that promotes HIV/AIDS prevention and addresses drug risk behaviours and 745 among them were tested for HIV and received their results and 239 of them were referred from HCT to other services. Additionally, 66 individuals were trained to promote HIV/AIDS prevention services and 15 were trained in HCT. Twelve new targeted condom and lubrication services and 7 new HCT outlets were established. MSM reported a variety of high-risk activities including not using condoms for anal sex, having sex while under the influence of alcohol or drugs and sharing needles (among injection drug users). However, MSM were willing to develop risk reduction strategies. Year one and two of the intervention has demonstrated the willingness of the NGOs to broaden their service delivery, improved integration of drug treatment, HIV intervention and other services, and has shown positive results across a number of risk behaviours among MSM.     

A forensic nursing protocol for initiating human immunodeficiency virus post-exposure prophylaxis following sexual assault

The use of human immunodeficiency virus post-exposure prophylaxis (HIV PEP) should be considered in the care of sexual assault patient populations. In order to effectively implement HIV PEP following sexual assault, healthcare providers need to have a working knowledge of HIV transmission risk factors following a sexual exposure and protocols for initiating HIV PEP. Being able to implement evidence-based practices that address each of these factors is paramount to successful prevention of HIV transmission following a sexual assault exposure. Most healthcare practitioners, however, lack the specialized knowledge needed to address these issues in the expeditious manner necessitated by a potential HIV exposure. Implications: This paper is designed to provide healthcare providers with a basic understanding of HIV transmission risk factors and the knowledge and skills needed to effectively implement HIV PEP following a sexual assault exposure.     

Evaluating the contribution of relapse prevention theory to the treatment of sexual offenders

In the last 10 years, relapse prevention (RP) has been adopted as the most popular framework for the treatment of sexual offenders. Although RP is conceptually similar to other forms of cognitive/behavior therapy, it has made an important contribution by focusing therapists' attention on the problem of longterm recidivism. In RP, posttreatment behavioral deterioration is not considered evidence that sexual offenders are untreatable; instead, lapses are considered as expected and workable problems. There are certain difficulties, however, with the application of RP to the treatment of sexual offenders. In some cases, RP has been interpreted so generally that it has had little real influence on preexisting practices. As well, it is not clear how some of the most distinctive concepts of RP (e.g., lapse/relapse, abstinence violation effect) should be applied to sexual offenders. Special efforts may also be required to convince sexual offenders that they are at risk before they are able to benefit from RP interventions.The views expressed are those of the author and do not necessarily reflect the views of the Ministry of the Solicitor General of Canada.     

Antibody-mediated depletion of viral reservoirs is limited in SIV-infected macaques treated early with antiretroviral therapy

The effectiveness of virus-specific strategies, including administered HIV-specific mAbs, to target cells that persistently harbor latent, rebound-competent HIV genomes during combination antiretroviral therapy (cART) has been limited by inefficient induction of viral protein expression. To examine antibody-mediated viral reservoir targeting without a need for viral induction, we used an anti-CD4 mAb to deplete both infected and uninfected CD4⁺ T cells. Ten rhesus macaques infected with barcoded SIVmac239M received cART for 93 weeks starting 4 days after infection. During cART, 5 animals received 5 to 6 anti-CD4 antibody administrations and CD4⁺ T cell populations were then allowed 1 year on cART to recover. Despite profound CD4⁺ T cell depletion in blood and lymph nodes, time to viral rebound following cART cessation was not significantly delayed in anti-CD4–treated animals compared with controls. Viral reactivation rates, determined based on rebounding SIVmac239M clonotype proportions, also were not significantly different in CD4-depleted animals. Notably, antibody-mediated depletion was limited in rectal tissue and negligible in lymphoid follicles. These results suggest that, even if robust viral reactivation can be achieved, antibody-mediated viral reservoir depletion may be limited in key tissue sites.     

2004-2007年中国法定报告性传播疾病流行病学特征分析

目的　了解法定报告性传播疾病（STDs）的流行病学特点，为制定针对性防治措施提供依据。方法　采用2004-2007年全国疾病监测信息报告管理系统报告的数据进行趋势及描述性分析。结果　2004-2007年间，淋病报告发病率呈下降趋势，梅毒、艾滋病（AIDS）发病率和人类免疫缺陷病毒（HIV）感染率呈上升趋势；3种性病报告发病率从15岁开始上升，25～29岁达发病高峰，之后淋病、AIDS逐渐下降；除5～14岁，梅毒报告发病率明显高于淋病和AIDS/HIV。从2006开始，梅毒男女性别比＜1，女性患者多于男性，而同期淋病、AIDS/HIV感染者男女性别比仍＞1，患者以男性为主。 结论　淋病、梅毒、AIDS/HIV均为性传播疾病，但流行病学特点并不完全相同，深入分析它们各自的特点，有助于描述疾病流行规律。从2004年开始梅毒发病率明显上升，目前需加强梅毒防控措施，降低梅毒发病率，并有助于控制AIDS/HIV的流行。     

Attitudes of university students towards HIV/AIDS

The purpose of this study was to assess, in one university in Finland, students' attitudes and feelings towards HIV/AIDS while they were studying for their first year at the University of Oulu. This study is part of a larger research project concerning HIV/AIDS in the Department of Nursing at the University of Oulu. The results can be used in planning and implementing health education for young people. The data were collected by using a questionnaire with both structured and open-ended questions. The study group consisted of 245 students who had started their studies in the autumn of 1993. The data were analysed by using cross tabulation (chi-square test) and inductively by content analysis. The most important source of knowledge concerning HIV/AIDS was television (84%) and 30% of the students had obtained their knowledge from a school nurse. Even when there was a lot of knowledge available to the students, they estimated their knowledge as insufficient and defined HIV more correctly than AIDS. Knowledge did not increase the use of safe sex but limited sexual behaviour. Religion had an importance for sexual behaviour. Female students were more sexually active than male students. The feelings towards HIV/AIDS were more often negative than positive or neutral and the students felt stronger negative feelings towards AIDS than HIV. The negative feelings were often based on fear. The differences between the faculties were minimal.     

大理市娱乐场所性服务人员性病艾滋病防治综合干预效果评价

目的评价大理市娱乐场所性服务人员AIDS综合干预效果,为AIDS综合干预工作提供参考。方法对项目覆盖区女性性服务人员进行一对一问卷调查,调查结果与基线结果进行比较。结果目标人群AIDS预防知识知晓率由2003年的75.50%上升到2005年的88.30%;传播知识的知晓率由5.90%上升到41.40%,干预前后差异有统计学意义。与商业性伴"最近一次"、"最近一月"使用安全套的比例分别由89.40%提高到97.22%、从71.27%提高到81.48%;与固定性伴安全套使用率仍不高,最近一月与固定性伴每次用安全套的频率仅为25.33%。结论通过综合干预的开展,有效地提高了干预点所在地目标人群的AIDS知识知晓率和安全行为率,但行为的改变需要长期持续的干预才能产生明显效果。